Acute pulmonary failure during remission induction chemotherapy in adults with acute myeloid leukemia or high-risk myelodysplastic syndrome

Ali Al Ameri, Charles Koller, Hagop Kantarjian, Farhad Ravandi, Srdan Verstovsek, Gautam Borthakur, Sherry Pierce, Gloria Mattiuzzi

Research output: Contribution to journalArticlepeer-review

23 Scopus citations

Abstract

BACKGROUND: Acute pulmonary failure during remission induction therapy is a serious complication in patients with acute myeloid leukemia (AML). To the authors' knowledge, the course and prognosis of such patients is not well known. METHODS: A total of 1541 patients referred for remission induction chemotherapy of AML or high-risk myelodysplastic syndrome were retrospectively reviewed. RESULTS: A total of 120 (8%) patients developed acute pulmonary failure within 2 weeks of the initiation of chemotherapy; 87 of these patients (73%) died during remission induction, whereas 17 (14%) achieved a complete response. The median survival among the 120 patients with early acute pulmonary failure was 3 weeks. Predictive factors for the development of early acute pulmonary failure by multivariate analysis were: male sex (P = .00038), acute promyelocytic leukemia (P = .00003), poor performance status (P = .001), lung infiltrates at diagnosis (P = .000001), and increased creatinine (P = .000005). Patients who had 0 to 1, 2, 3, or 4 to 5 adverse factors were found to have estimated predictive incidences of acute pulmonary failure of 3%, 13%, 23%, and 34%, respectively. CONCLUSIONS: Preventive approaches at the start of induction therapy in patients at high risk of pulmonary failure may improve the outcome of these patients.

Original languageEnglish (US)
Pages (from-to)93-97
Number of pages5
JournalCancer
Volume116
Issue number1
DOIs
StatePublished - Jan 1 2010

Keywords

  • Acute leukemia
  • Acute pulmonary failure
  • Adults
  • Prognosis

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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